Disappearance of a thrombotic microangiopathy-like glomerular lesion in a patient with a placental site trophoblastic tumor after hysterectomy.

Clinical Nephrology. Case Studies Pub Date : 2018-09-20 eCollection Date: 2018-01-01 DOI:10.5414/CNCS109440
Masato Sawamura, Atsushi Komatsuda, Mizuho Nara, Masaru Togashi, Hideki Wakui, Naoto Takahashi
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引用次数: 3

Abstract

A 32-year-old woman presented with amenorrhea after a normal childbirth and subsequently developed nephrotic syndrome. Renal biopsy showed a thrombotic microangiopathy (TMA)-like glomerular lesion with deposits of immunoglobulins, complements, and fibrinogen. Increased serum levels of the beta subunit of human chorionic gonadotropin, abnormal uterine findings from imaging studies, and endometrial biopsy findings suggested gestational trophoblastic disease. She was diagnosed with a placental site trophoblastic tumor (PSTT) after hysterectomy and, following treatment, her proteinuria disappeared. Follow-up renal biopsy showed the disappearance of the TMA-like lesion. To our knowledge, this is the first case report of the pathological remission of renal disease associated with PSTT.

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子宫切除术后胎盘部位滋养细胞瘤患者血栓性微血管病变样肾小球病变消失。
一位32岁的女性在正常分娩后出现闭经,随后发展为肾病综合征。肾活检显示血栓性微血管病变(TMA)样肾小球病变伴免疫球蛋白、补体和纤维蛋白原沉积。人绒毛膜促性腺激素β亚基血清水平升高,子宫影像学检查异常,子宫内膜活检结果提示妊娠滋养细胞疾病。她在子宫切除术后被诊断为胎盘部位滋养细胞瘤(PSTT),经过治疗,她的蛋白尿消失了。随访肾活检显示tma样病变消失。据我们所知,这是首例与PSTT相关的肾脏疾病病理缓解的病例报告。
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